Antidiabetic drugs: practice question

A Pharmacology question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Pharmacology · Antidiabetic drugs

Sample item

An elderly man with reduced renal function on glibenclamide has recurrent hypoglycaemia that returns hours after each dextrose bolus. Which drug is most appropriate to prevent the recurrences?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

B. Octreotide

Sulfonylurea overdose or accumulation keeps stimulating insulin release, so hypoglycaemia recurs after dextrose, which itself stimulates further insulin secretion. Octreotide suppresses insulin release from beta cells by acting on somatostatin receptors and is the preferred second-line agent.

Option by option

  • A. Intravenous hydrocortisone

    Hydrocortisone raises glucose slowly and does not suppress sulfonylurea-driven insulin release.

  • B. Octreotide (correct)

    Correct. It inhibits endogenous insulin secretion by acting at beta cell somatostatin receptors.

  • C. Glucagon infusion alone

    Glucagon is less useful because glycogen stores are limited and glucagon itself stimulates insulin release.

  • D. Metformin

    Metformin would not treat hypoglycaemia and is poorly suited to renal impairment.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

More Pharmacology questions

Questions about this Pharmacology question

What is the answer to this Pharmacology question?

The best answer is B, Octreotide. Sulfonylurea overdose or accumulation keeps stimulating insulin release, so hypoglycaemia recurs after dextrose, which itself stimulates further insulin secretion.

Why is "Intravenous hydrocortisone" not the answer?

Hydrocortisone raises glucose slowly and does not suppress sulfonylurea-driven insulin release.

Why is "Glucagon infusion alone" not the answer?

Glucagon is less useful because glycogen stores are limited and glucagon itself stimulates insulin release.

Why is "Metformin" not the answer?

Metformin would not treat hypoglycaemia and is poorly suited to renal impairment.

What concept does this question test?

It tests Antidiabetic drugs in Pharmacology. Octreotide suppresses insulin release from beta cells by acting on somatostatin receptors and is the preferred second-line agent.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Antidiabetic drugs?

Learn drugs as classes, then the exception in each class that an examiner would pick. Then use the flashcards and the other Pharmacology questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.